Lower Testosterone In Men Can Lead To Earlier Death

The findings back previous evidence that some men could benefit from 'testosterone replacement therapy' - the equivalent of hormone replacement therapy in women.

Testosterone deficiency becomes more common with age, occurring in 18 per cent of 70-year-olds who have andropause, sometimes called the male menopause.

A study of nearly 2,000 men aged 20 to 79 years presented to The Endocrine Society's 90th Annual Meeting in San Francisco adds to the scientific evidence linking deficiency of this sex hormone with reduced life expectancy, or increased death from all causes over time-so-called "all-cause mortality."

Overall, men with low testosterone levels had more than 2.5 times greater risk of dying during the next 10 years compared with men who had higher testosterone, the study found, backing earlier studies.

The men with low testosterone were older, more obese, and had a greater prevalence of diabetes and high blood pressure, compared with men who had higher testosterone levels, said lead author Dr Robin Haring, from Ernst-Moritz-Arndt University of Greifswald, Institute for Community Medicine. "It is very possible that lifestyle determines levels of testosterone," he said.

Low testosterone levels are linked to the metabolic syndrome - a cluster of metabolic risk factors that increase the chances of developing heart disease, stroke, and type 2 diabetes - and other health problems, including loss of bone and muscle mass, depression, and decreased libido.

In other work presented to the meeting by Prof Farid Saad of Bayer Schering Pharma, who has done research with Dr Ahmad Haider, they show that restoring normal levels in testosterone-deficient men led to major and progressive improvements in features of the metabolic syndrome.

Furthermore, men older than 63 benefited as much as younger men, they found. Treatment lasted a year and used a slow-release, injectable form of the hormone.

All 95 men in the studies (ages 34 to 69 years) had the metabolic syndrome. The first study showed that testosterone treatment significantly reduced waist circumference, ("bad") cholesterol, fats (triglycerides), and body mass index (a measure of body fat). Treatment also increased "good" cholesterol. Improvements were progressive over 12 months, indicating that benefits may continue past a year, Prof Saad said.

In the second study, the researchers divided the patient population into three groups by age: less than 57 years, 57 to 63 years, and more than 63 years.

They found that the oldest men had similar improvements in metabolic risk factors to the youngest men. "We conclude that if elderly men have a deficiency of testosterone, it is worthwhile to treat them with testosterone," he said.

As for side effects, he said that the risks are minor if levels are in the natural range seen in healthy men. Although it is not thought to trigger the cancer, it can aggravate existing prostate cancer. "It is very important to exclude any suspicion of prostate cancer before you start any treatment," he said.

The hormone also affects red blood cell formation, which helps treat anaemia and fatigue in men with low testosterone levels, though can increase blood thickness that puts men who may already have early heart disease at higher risk of heart attack and stroke.

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